经皮血管内支架成形术治疗颈动脉狭窄26例临床分析

目的:分析总结26例经皮血管内支架置入治疗颈动脉狭窄的方法、适应症和并发症的预防和处理。方法:所选病例均经脑血管造影确诊,围手术期及长期抗血小板聚集治疗,采用经股动脉插管,置入自膨式支架对颈动脉颅外段狭窄进行治疗。结果:26例手术均获得成功,3例出现不同程度脑血管痉挛,1例术中出现微栓子脱落轻度卒中,5例术中出现一过性心动过缓血压下降,2例术后持续性低血压,经积极处理未出现永久并发症,所有病例症状明显好转或消失,影像学上颈动脉狭窄得到有效改善,脑组织血管染色好转;随访5-18个月,未发生明显脑缺血症状,无发现支架内再狭窄病例。结论:颈动脉狭窄血管内支架治疗是一项安全有效的治疗手段,适应证的选择和术后的处理以及娴熟的操作技巧及脑保护装置的使用是手术成功的关键。

Percutaneous transluminal angioplasty and stenting for 26 cases with stenosis of carotid artery

Objective:To evaluate the operation method,indications and prevention from complication in 26 cases with stenosis of carotid artery by percutaneous transluminal angioplasty and stenting. Methods:The procedures of percutaneous transluminal angioplasty and scenting of carotid arteries were performed after the diagnosis of 26 cases with carotid artery stenosis which were confirmed by DSA and periprocedual and extended anticoagulation treatment. Results:All 26 carotid stems were successfully accomplished. Amomg...